Provider Demographics
NPI:1366699100
Name:HEALTHCARE QUALITY MANAGEMENT
Entity type:Organization
Organization Name:HEALTHCARE QUALITY MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:MAGEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:662-890-6939
Mailing Address - Street 1:8880 GERMANTOWN RD
Mailing Address - Street 2:STE 502
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-8519
Mailing Address - Country:US
Mailing Address - Phone:662-890-6939
Mailing Address - Fax:662-890-1890
Practice Address - Street 1:8880 GERMANTOWN RD
Practice Address - Street 2:STE 502
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-8519
Practice Address - Country:US
Practice Address - Phone:662-890-6939
Practice Address - Fax:662-890-1890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-23
Last Update Date:2008-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1320820001Medicare PIN